ENDOMETRIAL VOLUME AND ENDOMETRIAL FLOW INDICES IN PREDICTING THE SUCCESS OF IVF/ICSI CYCLES

مستودعات نظام جامعة عين شمس الرقمى

المؤلف Mohamed Mahmoud Ahmed
تاريخ الإدخال إلى قاعدة البيانات 2016-11-30T09:46:23Z
تاريخ الإتاحة الألكترونية 2016-11-30T09:46:23Z
تاريخ النشر 2016
المعرف الإلكترونى http://hdl.handle.net/1234567/145181
الخلاصة Embryo implantation represents a critical step of the reproductive process and consists of a unique biological phenomenon. The blastocyst comes into intimate contact with the endometrium and forms the placenta that will provide an interface between the growing fetus and the maternal circulation (Guzeloglu-Kayisli et al., 2009). Successful implantation requires a receptive endometrium, a functional embryo and a synchronized dialog between maternal and embryonic tissues (Simon et al., 2000). The human endometrium undergoes a complex series of organized proliferative and secretory changes in each menstrual cycle, and exhibits only a short period of receptivity, known as the ‘window of implantation’ (Strowitzki et al., 2006). Each month, the human endometrium undergoes a series of distinct cyclical changes in preparation to receive the developing blastocyst. Such changes necessitate well-controlled, dynamic remodeling of the endometrial microvasculature through the processes of angiogenesis and arteriogenesis (Smith, 2000; Rogers and Abberton, 2003). The standard method of endometrial dating is the histological evaluation of an endometrial biopsy (Noyes et al., 1950). Obviously, such an invasive method is not acceptable in order not to damage the endometrium. Therefore, endometrial receptivity should be ideally assessed before embryo transfer using a non-invasive method (Alcázar, 2006). . Transvaginal ultrasonography may represent theoretically such an ideal non-invasive technique. Several sonographic parameters have been used to assess uterine receptivity, including endometrial thickness, endometrial pattern and endometrial subendometrial and uterine blood flow (Chien et al., 2004). However, many studies performed in the last 15 years clearly show that all of these sonographic parameters have a low predictive value for determining endometrial or uterine receptivity (Friedler et al., 1996). Therefore, the method to predict endometrial receptivity has yet to be established. However with the advent of three-dimensional ultrasound it became possible to perform a reliable and reproducible sonographic endometrial volume calculations as well as an assessment of endometrial and subendometrial vascularization. Therefore, some researchers have evaluated the role of endometrial volume as well as subendometrial and endometrial vascularization for predicting uterine receptivity (Alcázar, 2006). So the aim of our study is to assess the value of measurement of endometrial volume and endometrial flow indices before embryo transfer in predicting the success of IVF/ICSI cycles. The design of our study is a prospective observational study and it was conducted in the Assisted Reproductive Technology Unit and Fetal Care Unit of Ain Shams University Maternity Hospital during the period from October 2014 to November 2015. It was conducted on fifty (50) patients undergoing intracytoplasmic sperm injection (ICSI). We included only patients aged 20-35 years old, with normal uterine cavity. The ovarian stimulation protocol, used in this study for all patients, was the long protocol, before ovarian stimulation therapy, patients instructed to use oral contraceptive pills from day 2 starting in the preceding cycle, then a standard regimen of GnRH agonist triptorelin (Decapeptyl®,0.1 mg, Fering, Kiel, Germany) was administrated subcutaneously in a daily dose 0.1mg beginning in the midluteal phase of the preceding cycle, this dose was continued till the day of hCG administration .This drug was used to prevent the pituitary gland from interfering with the function of the ovaries during ovarian stimulation. This is called “pituitary down regulation”. Subsequently, controlled hyperstimulation with human menopausal gonadotrophin (HMG, 75 IU FSH and 75 LH; Menogon®, Ferring, Kiel, Germany) was given by intramuscular injection starting in the second day of the stimulated cycle and continued till more than three follicles attain the diameter of 18-22mm. The dose was adjusted according to the age, built, or previous history of induction. The dose was increased or decreased depending on the response to the drug detected by folliculometry. On the day of hCG administration, 3D transvaginal ultrasound measurements were performed by the same observer after the patients had emptied their bladders. Measurements included: endometrial volume and 3 D Power Doppler parameters, endometrial vascularization index (VI), flow index (FI), vascularization flow index (VFI).
المشرفين على الرسالة Prof. Dr. Khaled Ibrahim Abdallah Prof. Dr. Ihab Foud Serag Eldin Allam
اللغة الإنجليزية
العنوان ENDOMETRIAL VOLUME AND ENDOMETRIAL FLOW INDICES IN PREDICTING THE SUCCESS OF IVF/ICSI CYCLES
عناوين أخرى حجم بطانةالرحم ومؤشرات تدفق الدم لبطانةالرحم في توقع نجاح دورات أطفال الأنابيب والحقن المجهري
النوع رسالة
إتاحة النص النص متوفر إلكترونياً
الجامعة Ain Shams
الكلية Medicine
القسم Obstetrics &Gynecology
الرقم الإلكترونى G10828
عدد الصفحات 163
الدرجة العلمية M.SC


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